The present invention relates to tubular medical devices and more particularly to catheters and cannulas that deliver visible light, infra red light or radiation, ultraviolet light or radiation, and other radiation along the course of the catheters and to the tips of the catheters and cannulas when inserted within a patient. The present invention utilizes various wavelengths of light to reduce or to eliminate bacterial growth in the airways of patients.
A patient presents to a medical practitioner with a wide variety of symptoms. Generally the practitioner checks for life threatening symptoms or conditions and then shifts to more chronic ailments. Life threatening conditions generally affect the airway, breathing, or circulation. Circulation conditions receive various cardiac treatments. Acute and chronic respiratory failure frequently requires placement of breathing tubes into the trachea either trans-nasally, trans-orally, or directly in the trachea of a patient. The tube can then provide air flow to the lungs either by spontaneous respiration or upon a ventilator. Beyond respiratory conditions, tubes also see usage in treating digestive conditions where a component of the digestive track requires a supported reopening. Tubes used for respiratory or digestive conditions remain open and allow for air or digestive matter to pass through. However, tubes at times, provide an eddy at their ends where infection vectors or digestive matter may collect. Such vectors and matter lead to infections that require additional care.
Over the years, various tube sumps have entered the market and connect sumps to ventilation, tracheal, and endotracheal tubes among others. A prior invention, U.S. Pat. No. 6,460,540 of the Applicant, suctions material out from the upper airway. The tube sump has a flexible, elongated, hollow main body and then a plurality of separate clips or clamps attached to the main body. The hollow main body allows for suction to drain any infection vectors or digestive matter that accumulates above the endotracheal tube cuff when located in a patient's trachea. In the setting of life support tubes, such as endotracheal tubes “ETT” and tracheostomy tubes, the upper airway of a patient frequently becomes contaminated and colonized by bacteria.
Ventilator associated pneumonia, “VAP”, a common medical illness, has high morbidity and mortality. VAP arises from micro and macro aspiration of contaminated secretions from the area of the pharynx and trachea. Methods to remove secretions from these areas and to reduce the microbiologic load have reduced the incidence of VAP as shown by various studies. Endotracheal tubes serve as tubular medical conduits through which oxygen, various gases, and medications pass while ventilating a patient. The proximal end of an ETT, outside of the patient, attaches to a ventilator, an oxygen tubing apparatus, or to an anesthesia machine for general anesthesia. The distal end of the ETT, inside of the patient, lies in the trachea and seals to the trachea by a circumferential air filled cuff which allows positive pressure ventilation of the patient. Contaminated and infected secretions tend to accumulate in the space above the cuff, at the cuff and below the cuff when an ETT occupies a patient's tracheobronchial tree. Treatments or effects that sterilize these areas would provide plenty of benefits to patients with a host of ailments. Furthermore, an ETT itself becomes colonized by infection internally along its luminal axis. Secretions retained within the luminal axis frequently obstruct airflow and the passage of suction catheters. Such a blockage of airflow can lead to life threatening artificial airway obstruction and occasionally requires removal of the life support tube and its replacement with a new tube.
Further, various prior art devices access the region of the patient's glottis and evacuate secretions from these areas. However, infection vectors may remain behind at the distal end of prior art devices. VAP occurs as a common complication of mechanical ventilation and it carries a high degree of morbidity, mortality and cost. Medical practitioners know that contaminated material in these areas migrates into the lungs around the endotracheal tube cuff and then causes pneumonia in patients. Further research has also shown that evacuation of these secretions and to some extent, decontamination of these secretions prevents VAP. Various wavelengths of light are known to suppress growth or kill microbes. The present invention provides an embodiment that decontaminates secretions using light emitting diodes or fiber optic light guides to conduct light into the airway.
A further alternate embodiment builds upon the prior art as it utilizes fiber optics upon a catheter or cannula to deliver light and select radiation to a location where secretions accumulate. This fiber optic energy delivery system then sterilizes, decontaminates, or otherwise reduces the microbial counts in the aero or digestive lumens or spaces of a patient. Transmission of various wavelengths of light into the desired space within a patient may reduce the likelihood or severity of infections from microbial colonization and contamination of the mucosa and accumulated secretions.
This embodiment of the invention includes a fiber optic delivery system that transmits antimicrobial wavelengths along a conduit parallel to an ETT or other medical tube within a patient. The conduit may be located internal or external to an ETT. This embodiment utilizing light and other radiation may be applied to or used with a tracheostomy tube, such as a light enhanced inner cannula. The unique feature of this embodiment of the invention is silica, fluropolymer, or plastic light guides, singular or bundled, bare or cladded, for delivering light within a patient to the location of greatest need. Though light diffusion or emission may occur from various alterations in the cladding, the present invention staggers the tips of the fiber optics in bundled applications or other tip treatments.